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2 results on '"Penza, O."'

1. Monitoring the quality of laboratories and the prevalence of resistance to antituberculosis drugs: Italy, 1998–2000

Author

Migliori, G. B., Fattorini, L., Vaccarino, R., Besozzi, G., Saltini, C., Orefici, G., Iona, E., Matteelli, A., Fiorentini, F., Codecasa, L. R., Casali, Lucio, Cassone, A., De Santis, A., Giorgio, V., Vinciguerra, P., Angarano, G., Petrozzi, L., Costa, D., Gozzellino, F., Perboni, A., Marchetti, D., Pascali, A., Falcone, F., Mariano, V., Rizza, F., Pretto, P., Turano, A., Carosi, G. P., Farris, A. G., Ligia, G. P., Orani, G., Farris, B., Foschi, C., Trucco, G., Aiolfi, S., Ceruti, T., Parpanesi, M., Calabro, S., Felisatti, G., Tortoli, E., Nutini, S., Montini, G., D'Ambrosio, V., Ceraminiello, A., Bernorio, S., Buono, L., Montesano, P., Vinci, E., Sabato, E., Gamba, S., Crepaldi, P., Magliano, E., Penati, V., Vaccarino, P., Astolfi, A., Bertoli, G., Rupianesi, F., Losi, M., Richeldi, L., Ferrara, Giovanni, Minuccio, E., Napolitano, G., Molinari, G. L., Saini, L., Garzone, A., Vertuccio, C., Marcias, S., Menozzi, M., Marone, P., Peona, V., Nascimbene, C., Pasi, A., Cascina, A., Monaco, A., Penza, O., Pasticci, Maria Bruna, Bistoni, F., Sposini, T., Colorizio, V., Confalonieri, M., Bottrighi, P., Macor, G., Moretti, G., Fatigante, R., Barbaro, A., Agati, G., Zaccara, F., Viola, S., Le Donne, R., Farinelli, G., Mancini, D., Ermeti, M., Longi, R., Tronci, M., Bisetti, A., Altieri, A., and Fadda, G.

Subjects
Pulmonary and Respiratory Medicine, medicine.medical_specialty, Tuberculosis, Prevalence of resistance, Drug Resistance, Antitubercular Agents, Drug resistance, Proficiency testing, Drug, Immigrant, Susceptibility testing, Emigration and Immigration, Humans, Italy, Laboratories, Prevalence, Drug Resistance, Multiple, Bacterial, Tuberculosis, Multidrug-Resistant, Internal medicine, medicine, Ethambutol, business.industry, Public health, Isoniazid, Bacterial, Multidrug-Resistant, medicine.disease, Surgery, Streptomycin, business, Multiple, Rifampicin, medicine.drug
Abstract

In 1998 a network of 20 regional tuberculosis (TB) laboratories (the Italian Multicentre Study on Resistance to Antituberculosis drugs (SMIRA) network) was established in Italy to implement proficiency testing and to monitor the prevalence of drug resistance nationwide. The network managed 30% of all TB cases reported in Italy each year. The aim of the present report is to describe: 1) the accuracy of drug-susceptibility testing in the network; 2) the prevalence of drug resistance for the period 1998-2000. Data were collected from the network laboratories. Sensitivity to streptomycin and ethambutol increased from the first survey (1998-1999) to the second survey (2000) from 87.7 to 91.9%. Specificity, predictive values for resistance and susceptibility, efficiency and reproducibility were consistent in both surveys. In previously untreated cases, the prevalence of multidrug-resistance was the same in both surveys (1.2%), while a slight decrease from the first to the second survey was observed for monoresistance to rifampicin (from 0.8 to 0.4%) and isoniazid (from 2.9 to 2%). The significant association found between isoniazid resistance and immigration is a useful indicator for both clinicians managing individual tuberculosis cases and public health services planning control strategies.

Published
2003

2. GP management of community-acquired pneumonia in Italy: The ISOCAP study

Author

Sanguinetti, C. M., Benedetto, F., Donner, C. F., Del Prato, B., Fogliani, V., Lorgroscino, C., Mistretta, A., Schito, G., Cacciani, G., GIORGIO WALTER CANONICA, Dolcetti, A., Falcone, F., Lo Cicero, S., Neri, M., Pozzi, E., Schiavina, M., Munafò, G., Parentini, G., Penza, O., Principe, R. S., Saltini, C., Tubaldi, A., Agati, G., Crimi, N., Ferrara, G., Francesca, F., Lsedda, M., Logroscino, C., Mirabella, S., Moretti, A., Picciolo, F., Viola, B., Parola, D., and Zanello, A.

Subjects
Pulmonary and Respiratory Medicine, Pediatrics, medicine.medical_specialty, Community-acquired pneumonia, diagnosis, lcsh:Medicine, Physical examination, remission, medicine, COPD, medicine.diagnostic_test, treatment, business.industry, Mortality rate, Incidence (epidemiology), lcsh:R, medicine.disease, Pneumonia, Concomitant, general practitioner, pulmonary specialist, Ceftriaxone, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

Background. Community-Acquired Pneumonia (CAP) is still a significant problem in terms of incidence, mortality rate, particularly in infants and the elderly, and socioeconomic burden. General Practitioners (GPs) are the first reference for patients with this disease, but there are few published studies regarding the outpatient treatment of CAP. Methods. The ISOCAP study aimed to identify the type and outcome of the diagnostic-therapeutic management of CAP by GPs in Italy, within the framework of developing a closer interrelationship between GPs and pulmonary specialists. Thirty-six Pulmonary Divisions throughout Italy each contacted 5 local GPs who agreed to recruit the first 5 consecutive patients who consulted them for suspected CAP within the study’s 1-year observation period. Results. A total of 183 GPs took part in the study and enrolled, by the end of the observation period, 763 CAP patients; of these, complete data was available for 737 patients [males=373, females=364, mean age (±SD) 58.8±19.6 years]. 64.4% of patients had concomitant diseases, mainly systemic arterial hypertension and COPD. Diagnosis of CAP was based by GPs on physical examination only in 41.6% of cases; in the remaining chest X-ray was also performed. In only 4.6% of patients were samples sent for microbiological analysis. All patients were treated with antibiotics: 76.7% in mono-therapy, 23.3% with a combination of antibiotics. The antibiotic class most prevalently used in mono-therapy was cephalosporin, primarily ceftriaxone; the most frequently used combinations were cephalosporin+macrolide and cephalosporin+quinolone. Mono-therapy was effective in 70% of cases, the combination of two or more antibiotics in 91.2% of patients. Overall treatment efficacy was 94.7%; hospitalisation was required in 8.5% of cases. Conclusions. Outpatient management of CAP by GPs in Italy is effective, hospitalisation being necessary only in the most severe cases due to age, co-morbidities or extent of pneumonia. This signifies a very significant savings in national health costs.

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